Background Patients with rheumatic diseases (RD) have an increased risk of developing osteoporosis (OP) compared with healthy population due to chronic inflammation, low physical activity and using some kind of medications. Persons with RD and OP require prolonged osteoporosis treatment due to increased risk of fracture.
Objectives To evaluate adherence and persistence with different osteoporosis medications in RD patients with OP during 3 years.
Methods We conducted a retrospective study of 204 patients (82% women, mean age 54±11 years) with RD (93 – rheumatoid arthritis, 48 – systemic sclerosis, 39 – systemic lupus erythematosus and 24 – ankylosing spondylitis), whom OP was diagnosed in 2013. In 2016 we revised there medical charts for collection information on the osteoporosis treatment and performed telephone contact for patient's self-reporting.
Results 196 (96%) patients started the OP treatment. Among them 26% - alendronate, 24% received alfacalcidol or supplements of calcium and vitamin D only, 16% - stroncium ranelate, 12% - ibandronate, 9% zoledronic acid, 8% - calcitonin and 5% - denosumab.
8 (4%) patients didn't start the drug treatment at all, 72 (35%) patients were persisted less than 12 months, 47 (23%) – 2 years and 77 (38%) – 3 years. Mean persistence was 2.1, 2.4, 1.6, 1.7, 1.9, 2.0 years for alendronate, alfacalcidol, stroncium ranelate, ibandronate, zoledronic acid, denosumab, respectively. 61 (31%) persons were switched from one antiosteoporotic medication to another due to side effects, inconvenient dose regimen or other reasons. Persistence to oral therapy was better among women than men (p<0.05), especially on daily regimen. Discontinuers were less likely than persistent subjects to visit rheumatologist and BMD measurement each year for control of treatment (p<0.05). Patients with ankylosing spondylitis were less persistent than persons with other RD. Presence of OP fractures in anamnesis had no significant influence on adherence. 8 (4%) patients had fractures during retrospective period, among them 6 - received only supplements of calcium and vitamin D, 1 - zoledronic acid once and 1 – without OP therapy.
Conclusions Only 1/3 of patients with RD received antiosteoporotic drugs during 3 years. Visits to rheumatologist and BMD measurements increased subject's persistence. Improving the quality of medical care can be achieved through education and motivation of patients for a long-term treatment of OP.
Disclosure of Interest None declared